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A number of common contagious diseases (Table 18-1) have special significance in the athletic setting. For the athletes, this may mean not being able to continue participation, subpar performance, or risk of potentially serious complications as a result of continued physical stress.

Sports in which outbreaks or clusters of contagious diseases have been reported are listed in Table 18-2.1 Infections in the athletic settings can be transmitted via either person-to-person spread or common-source spread (Table 18-3).1–6 The most common infection transmitted by direct contact is Herpes simplex virus infection among wrestlers and rugby players. Outbreaks associated with person-to-person spread have also been caused by Staphylococcus aureus, Group A Streptococci, and fungi and involve participation in wrestling, basketball, football, rugby, and orienteering.2 The most frequently reported common-source infections are owing to enteroviruses. Outbreaks of aseptic meningitis and pleurodynia have been documented in football and soccer players associated with oral contamination of shared water sources and drinking containers.2 Most cases of aseptic meningitis are caused by echoviruses (types 5, 9, 16, 24) and Coxsackie viruses (types B1, B2, B4, B5) from sharing of common contaminated source of drinking water.1,5 Epidemics of measles among athletes and spectators have been reported, spread by air-borne droplets in crowded confined environments in basketball, wrestling, and other sports necessitating mass immunizations and relocation or cancellation of events.3